Buprenorphine and Office-Based Treatment of Opioid Use Disorder-View Presentation

Video Transcription

Video Summary

The video transcript outlines a buprenorphine course for treating opioid use disorder (OUD), focusing on various aspects of treatment, including pharmacology, evaluation, induction, maintenance, and dealing with special populations like pregnant patients and adolescents. The course involves several expert speakers discussing the history, benefits, and challenges of using buprenorphine, methadone, and naltrexone. 

Key topics covered include: 
1. <strong>Initiation and Stabilization</strong>:
   - Importance of patient in withdrawal before starting buprenorphine.
   - Adjusting dosages based on individual patient responses and needs.
   - Challenges with fentanyl in current opioid use, requiring updated initiation approaches.

2. <strong>Psychiatric and Co-occurring Disorders</strong>:
   - Challenges in treating OUD patients with co-existing psychiatric disorders like depression, anxiety, and PTSD.
   - Importance of addressing mental health to improve treatment outcomes.

3. <strong>Special Populations</strong>:
   - Pregnant patients: Weighing risks of different buprenorphine formulations (mono vs. combo) and managing neonatal opioid withdrawal syndrome.
   - Adolescents: Advocating for medication-assisted treatment despite ongoing brain development.

4. <strong>Counseling and Behavioral Interventions</strong>:
   - Utilizing motivational interviewing, CBT, and 12-step programs as part of comprehensive treatment.
   - Encouragement for engaging patients in therapy, though not mandatory.

5. <strong>Practical Aspects</strong>:
   - Legal issues and documentation, particularly around the DEA's requirements.
   - Effective use of drug testing and addressing issues like co-substances and potential diversions.

6. <strong>Management of Pain and Emergency Situations</strong>:
   - Strategies for treating acute pain and perinatal management while on opioid use disorder medications.
   - Tailoring pain management protocols in surgical and chronic pain contexts.

Key takeaways emphasize the importance of individualized treatment plans, the integration of counseling with medication, and staying updated with emerging challenges like fentanyl and novel synthetic opioids.

Keywords

buprenorphine

opioid use disorder

OUD

pharmacology

induction

maintenance

special populations

pregnant patients

adolescents

methadone

naltrexone

psychiatric disorders

counseling

pain management

fentanyl